How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $524.81 | Professional | None | $467.74 | $478.63 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | None | $426.58 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,548.82 | Facility | None | $512.86 | $851.14 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $1,122.02 | Professional | None | $416.87 | $537.03 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $758.58 | Professional | None | $389.05 | $446.68 | $758.58 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,096.48 | Professional | None | $398.11 | $602.56 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $588.84 | Professional | None | $389.05 | $389.05 | $588.84 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $52.48 |
Where Maryland sits
The same service costs 7.6 times more in Oklahoma than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 42nd of 51
$537
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.